García Y Sánchez J M, Gómez Rodríguez C L, Pacheco Rubio G
Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, IMSS, Instituto Mexicano del Seguro Social, Avenida Cuahtemoc, #330, Colonia Doctores, Mexico, Mexico.
J Maxillofac Oral Surg. 2018 Jun;17(2):218-227. doi: 10.1007/s12663-017-1021-z. Epub 2017 Jun 12.
Based on the new concepts of the modified Le Fort III osteotomy (MLFIIIO), Three variations of this technique are implemented: (A) the modified osteotomy Le Fort III Champy (1980) technique to be described with the use of surgical guides, and subciliary approach or an transconjunctival approach. Excellent technique for horizontal advancement no further to 6 mm, without requiring any type of graft.. (B) The modified Le Fort III osteotomy in "Z": to solve horizontal (posterior anterior) problems of more than 6 mm without bone grafting. It is itself a modification of the technique described by Champy. (C) The modified Le Fort III osteotomy ascending: modified the original technique described by Bell and Epker with interpositional grafts, was modified by the called ascendant, making it higher in cases where the patient has an acceptable nasal bridge, but exorbitism the lateral wall of the orbit. Le Fort III osteotomy combined with a Le Fort I osteotomy and a front implant.
As pointed out in Part I for the modified oblique Le Fort III osteotomy, methods for the design of the osteotomy Le Fort III property will depend on the requirements of individual patients, and this has led us to design specific techniques for the deformity.
Patients have a right projection of the middle third, and protection of the eyeball.
The techniques presented for the advancement of the middle third have excellent results with the ability to be tailored to each patient deformity.
基于改良的勒福Ⅲ型截骨术(MLFIIIO)的新概念,实施了该技术的三种变体:(A)改良的勒福Ⅲ型尚皮截骨术(1980年),将使用手术导板进行描述,并采用睫毛下或经结膜入路。这是水平推进不超过6毫米的极佳技术,无需任何类型的植骨。(B)“Z”形改良勒福Ⅲ型截骨术:用于解决超过6毫米的水平(后前)问题,无需植骨。它本身是尚皮所描述技术的一种改良。(C)改良的上升型勒福Ⅲ型截骨术:对贝尔和埃普克所描述的原始技术进行改良,采用间置植骨,被称为上升型,在患者鼻梁可接受但眼眶外侧壁有眼球突出的情况下使其更高。勒福Ⅲ型截骨术联合勒福Ⅰ型截骨术和前植入物。
如第一部分所述的改良斜行勒福Ⅲ型截骨术,勒福Ⅲ型截骨术特性的设计方法将取决于个体患者的需求,这促使我们为畸形设计特定技术。
患者中面部有正确的突出度,眼球得到保护。
所呈现的中面部推进技术效果极佳,能够根据每个患者的畸形情况进行定制。